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    Can States Pay for Bird Flu Preps?

    State Officials Worried About the Cost of Getting Ready for Possible Pandemic

    Who Pays for Bird Flu Drugs? continued...

    Schaefer said she does not yet know how much of the drug her state may need to purchase in order to be ready for a potential outbreak. But she worried that under current financial conditions, purchasing the drug could be "off the table" for Nebraska.

    The federal plan calls for $100 million -- out of a proposed $7.1 billion total -- to go to assisting states with readiness plans. That money -- an average of $2 million per state -- won't go far enough, says Marc Metayer, Vermont's deputy commissioner for public safety.

    "Not when you start dividing it up among the states," he says.

    Getting Around the Financial Shortfall

    Julie Eckstein, director of the Missouri Department of Health and Senior Services, says her state does not have enough funds to increase hospital capacity to handle a potential wave of sick patients. "Investing in that means that we're not investing in another part of the health system," she says.

    But shortfall is not a problem because Missouri planners have instead focused on improving connections between hospitals, food suppliers, businesses, government agencies, and any other groups that may play a role in maintaining normalcy if a pandemic hits.

    "There are lots of cheap things" cities and states can do to prepare, Eckstein says. "It doesn't take federal money to create those relationships."

    Leavitt, a former Utah governor, said he was "intensely aware" of the financial pressures states face in preparing for a pandemic. Congress has not yet decided how money in the proposed $7.1 billion plan will be spent, meaning that states could get more help.

    Georges Benjamin, MD, executive director of the American Public Health Association, tells WebMD that states are not able to prepare as quickly as they could, both because of financial shortfalls and a lack of political will.

    He noted that Congress cut public health aid to states by $120 million this year before the federal plan proposed to spend $100 million for local pandemic readiness.

    "To take $120 million away and then put $100 million on the table doesn't add up," Benjamin says.

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